2 replies to this topic

[Rucko]

Hello all.  I've been gluten free for 4 years and 4 month after being undiagnosed for at least 25 years. I still have a bunch of lingering symptoms however, even though my blood test confirms that I am indeed gluten free.  I asked my GP if I could get a repeat endoscopy to see if that could explain part of my problems.  I had one recently and I got a copy of the lab report when I saw him today.  He didn't really explain it, just said I still have villous atrophy.  I'll be going to the gastroenterologist in June so will be able to find out for sure, but until then maybe some of the experts would be able to translate:

 

         minimal focal nonspecific crypt hyperplastic villous atrophy

 

Looking up the words individually isn't helping all that much.  Here's hoping some of the angels on the site can help!!

 

P.S.  My GP who told me I needed to see a psychiatrist a couple of months ago, was much nicer to me now that he knows there is still something wrong...  

[luvs2eat]

copy and paste the entire thing into google. A bunch of articles come up that should help!

[Fenrir]

I work in medical coding so terminology is something I'm good at and I also happen to code pathology reports a lot as well.

 

From what you posted it seems they are using unusual terminology for this sort of biopsy. Essentially, they are trying to say there is a minimal amount of crypt hperplasia and low grade villous atrophy.

 

To break it down further, Villious atrophy is typically seen in celiac disease as well crypt hyperplasia.

 

Villious atrophy is when your villi are blunted or flattened to some degree. Since villi are the things in your intestines that absorb nutrients having them damaged can affect nutrient absorbtion and cause many of the symptoms we celiacs have. Villious atrophy is the most important part of the biopsy findings, if there is none you are much more likely not to have celiac disease (though it is not impossible) and the presence of atrophy in the right grade is a hallmark of Celiac disease. Typically, the pathologist will give your atrophy a Marsh grade of 0-3c (0,1,2,3a,3b. 3c).  Marsh grade 0-1 are unlikely celiac, 2 is inconclusive (depending on your medical history/labs...ect), and 3a or higher is positive diagnosis of celiac.

 

Crypt hpyerplasia is something that goes along with atrophy and helps with the diagnosis and they also will note excess leukocytes. Between atrophy, leukocytes, and crypt hyperlasia a positive celiac diagnosis can be made via biopsy.

 

The part that is curious about what you posted is the note about it being "minimal" "focal" and "non-specific".

 

So, it looks like you have hyperplasia of the crypts and atrophy at minimal level which seems like it would indicate a low marsh grade. Focal and non-specific can mean that there was a very small area of the biopsy that showed hyperplastic crypts and atrophy and that it is not specific enough to diagnose anything with.

 

Essentially, the way I read it, is that you have some hyperlasia of the crypts and some atrophy of the villi but it seems the pathologist may think that they do not see enough to positively diagnose celiac disease. This is just my best guess, it takes a while to get used to how any given pathologist uses terminology and I'm not familiar with your pathologist's way of dictation so I could be wrong. 

The first thing I would do is ask if there were any notes about leukocytes or if a Marsh Grade was given.